Dr. Kevin Most: Baby Boxes and Sleep

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Dr. Kevin Most

The importance of sleep and rest for our bodies cannot be underestimated. It impacts our immune system, our mood, our energy and our safety. This past week we saw two major stories about sleep, one on infants and one on sleeping aids.

Baby Boxes

In the past we have discussed SIDS and the importance of placing the child on their back in the “back to bed” promotion. We also discussed how experts are now telling parents that the baby should actually sleep in their bedroom for the first 6 months of their lives. Both of these are thought to lower the incident of SIDS. This past week we saw that the concept of “baby boxes” is hitting the US. Baby boxes have been used in Europe for decades but recently we have seen the increased use of them in the US.

What is a baby box? Exactly what it sounds like, it is a cardboard box. It is made of non toxic cardboard and has a mattress and a tightly fitted sheet. The baby is placed in the box on their back and with no other items in the box. It sounds very simple and it is. This simple box is safe and portable and allows for parents to easily have a child sleep in their bedroom. A company in New Jersey is giving away over 100,000 free baby boxes. What they found in New Jersey was that 93% of SIDS deaths in their state were related to sleep environments. It is a great program where in order to get the free box, parents must pass an online educational program on infant health and safety.

Does it work? In Finland where these are used regularly, they have reached one of the lowest incidents of SIDS in the world. Mothers in Finland are provided the boxes thru the government. The box in Finland is not only a sleeping box but also is filled with items new parents need that have been reviewed for their safety. They include snowsuits, hats, and sleepers. This started in the late 30’s for low income families but soon was expanded when it was noted that these children had improved health. In Finland the baby sleeps in the box for the first 4 months of life and their rate of SIDS is one of the lowest in the world.

This simple item can decrease the chance of SIDS in many developing countries as the sleeping environment for many is less than ideal. It also allows the parents to make sure that they understand a safer environment as well as having safe clothes to start with. Great educational opportunities in sleeping habits as well as other safety ideas are shared with the box.

Sleep aids

Close to 50 % of Americans have insomnia or complain of poor sleeping habits. Because of this patients will look to an aid in order to help them sleep. In the United States alone close to 70million prescriptions for sleeping pills are filled each year. These are filled by the 10 million Americans who currently take prescription medications for sleep. There is a large multiplier of that number who take OTC sleep aids, like Benadryl, Tylenol PM, Advil PM and Nyquil.

Sleeping pills are often aids to allow you to fall asleep quickly. Some of these drugs can be highly addictive so often they are prescribed in small amounts while changing sleeping habits or helping someone get over a significant life event. There are many types of sleeping pills and some of the newer medications are much safer as they have lower addictive properties. Some actually effect hormones in the brain like melatonin.

There have been many studies that have shown that short term use of sleep aids has minimal negative effect on individuals. However there are more studies that show that the long term daily use of some sleep aids is not good for your overall health. Some studies have shown that daily use of benadryl may increase your chance of dementia.

The other ways sleeping pills are not safe is that they can cause sleep walking, sleep eating and even sleep driving. The side effects of these medications can be extensive. So although we feel that the simple answer is a pill it in fact may do more harm than good.

The science of sleep has grown dramatically, especially in the patient who has something called OSA or Obstructive Sleep Apnea. In this condition patients essentially stop breathing for extended periods of time while they sleep. The impact of this has many health changes that are detrimental.

Sleep hygiene tips

  1. Go to bed at the same time each night and rise at the same time each morning.
  2. Make sure your bedroom is a quiet, dark, and relaxing environment, which is neither too hot or too cold.
  3. Make sure your bed is comfortable and use it only for sleeping and not for other activities, such as reading, watching TV, or listening to music. Remove all TVs, computers, and other “gadgets” from the bedroom.
  4. Avoid large meals before bedtime.
  5. Avoid caffeine drinks for at least 4 hours before sleeping
  6. Many suggest a warm shower to relax one before sleep

Now if those things don’t work, seeing your doctor is a good idea. But before you go to the doctor collect information for him to review in a sleep diary. For 7-14 days capture information each day, what time did you go to bed, what time did you awake, did you wake during the night, if so what time. Did you take any naps that day. Did you exercise, if so what time. Did you drink alcohol, if so how much and at what time. Did you drink caffeine drinks, if so how much and at what times. Information like this will allow the doctor to make recommendations and perhaps prescribe a prescription that may help you sleep. The prescription may be a medication or it may be a recommendation of a pattern he would like you to try prior to a medication